Use of acetaminophen in pregnancy associated with increased asthma symptoms in children

Children who were exposed to acetaminophen prenatally were more likely to have asthma symptoms at age five in a study of 300 African-American and Dominican Republic children living in New York City. Building on prior research showing an association between both prenatal and postnatal acetaminophen and asthma, this is the first study to demonstrate a direct link between asthma and an ability to detoxify foreign substances in the body. The findings were published this week in the journal Thorax.

The study, conducted by the Columbia Center for Children's Environmental Health at Columbia University's Mailman School of Public Health, found that the relationship was stronger in children with a variant of a gene, glutathione S transferase, involved in detoxification of foreign substances. The variant is common among African-American and Hispanic populations. The results suggest that less efficient detoxification is a mechanism in the association between acetaminophen and asthma.

The researchers assessed the use of analgesics during pregnancy and found that 34 percent of mothers reported acetaminophen use during pregnancy, and 27 percent of children had wheeze, an asthma-related symptom. The children whose mothers had taken acetaminophen were more likely to wheeze, visit the emergency room for respiratory problems, and develop allergy symptoms, compared to those children whose mothers did not take acetaminophen. The risk increased with increasing number of days of prenatal acetaminophen use. The children in this study live in neighborhoods of New York City that have been the hardest hit by the asthma epidemic: Northern Manhattan and the South Bronx.

Acetaminophen use among children in the U.S. has increased substantially since the early 1980s and has become increasingly common among women during pregnancy so that most women in the U.S. take acetaminophen during pregnancy. This increase coincided with a doubling of the prevalence of asthma among children in the country between 1980 and 1995.

"These findings might provide an explanation for some of the increased asthma risk in minority communities and suggest caution in the use of acetaminophen in pregnancy," says Matthew S. Perzanowski, PhD, assistant professor of Environmental Health Sciences at the Mailman School of Public Health.

Reasons for prenatal acetaminophen use vary, but in this study population the observed associations with headaches suggest pain management as likely; however, other host factors that caused mothers to take acetaminophen and also cause asthma may explain their association. While infection is one such potential confounder, the Mailman School researchers found no association between the reported use of antibiotics and acetaminophen, and adjustment for antibiotic use during pregnancy did not affect the results.

According to the researchers, the prevalence of current wheeze diminished as the children aged, from 40 percent at age one year to 25 percent, 17 percent and 27 percent at ages two, three, and five, respectively. However, the association between prenatal acetaminophen exposure and current wheeze strengthened as the children aged.

The Columbia Center for Children's Environmental Health study adjusted relative risks for sex, race/ethnicity, birth order, maternal asthma, maternal hardship, exposure to environmental tobacco smoke, antibiotic use and postnatal acetaminophen use.

In a similar study conducted in the UK, the frequency of acetaminophen use during pregnancy and the magnitude of association in the UK study were similar to that in New York City.

via Use of acetaminophen in pregnancy associated with increased asthma symptoms in children, 4-Feb-2010.

For years studies said it is safe, even good for you, and then ... oops... not really.  You've got asthma. Sorry. Oh well. The image above came from this story:

No Link Seen Between Acetaminophen, Birth Defects

... Overall, the study found, there was no evidence linking mothers’ acetaminophen use in the first trimester to a heightened risk of any birth defect.

In fact, women who took the medication to treat a first-trimester fever had a lower risk of certain birth defects — including gastroschisis — than women who did not treat their fevers with acetaminophen.

Researchers led by Dr. Marcia L. Feldkamp, of the University of Utah in Salt Lake City, report the findings in the January 2010 issue of the journal Obstetrics & Gynecology. ... SOURCE: Obstetrics & Gynecology, January 2010.

via ABC News.  January 2010.

This next article drops the "may be" and says  "Baby Acetaminophen Tied to Asthma".

46% Increased Risk of Asthma With Baby Acetaminophen Use

... Babies who get acetaminophen -- Tylenol is one brand -- have an increased risk of childhood asthma.

Acetaminophen, often given to treat fevers in the first year of life, also upped the risk of eczema and having a runny nose and itchy eyes.

The finding, from an international study of 205,487 children in 31 countries, does not prove acetaminophen causes asthma, eczema, or nose/eye problems.

But it raises important safety concerns about the most commonly used drug in the U.S.: the fever-reducing painkiller acetaminophen (also known as paracetamol), the main ingredient in Tylenol. ...

Beasley recommends that parents give children acetaminophen only when they have a fever of more than 101 degrees Fahrenheit.

The study shows:

• A 46% increased risk of asthma at ages 6-7 years in kids who got acetaminophen for fever in their first year of life.


• A 48% increased risk of runny nose and red, itchy eyes at ages 6-7 in kids who got acetaminophen for fever in their first year of life.


• A 35% increased risk of eczema at ages 6-7 in kids who got acetaminophen for fever in their first year of life.


• A threefold higher risk of current asthma symptoms in 6- to 7-year-olds who took acetaminophen at least once a month compared with those who did not take the drug.


• 22% of severe childhood asthma is linked to acetaminophen use during the first year of life.


• 38% of severe childhood asthma is linked to acetaminophen use later in childhood.

... Does Acetaminophen Cause Asthma? ...

• The link between acetaminophen and asthma is strong.


• The more acetaminophen a child uses, the higher that child's risk of severe asthma.


• Acetaminophen is linked to asthma in many different cultures with different medical practices.


• Acetaminophen use came before asthma symptoms appeared.


• Asthma prevalence shot up in the same years acetaminophen use became widespread.

...  via WebMD Sept. 18, 2008